Organization Active NPI

Lavender Vision PLLC

Doing business as Lavender Vision

  • Optometrist
  • Sequim, WA
National Provider Identifier
1164365367
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAVENDER VISION PLLC
Doing business as
Lavender Vision
Practice address
955 W Washington St
Sequim, WA 98382-3266
Phone
(360) 406-2036
Fax
(360) 406-2037
NPI assigned
Apr 13, 2026
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Emily Keister, OD
Title
Doctor/Owner
Phone
(360) 406-2036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

955 W Washington St
Sequim, WA 98382-3266

Mailing address

955 W Washington St
Sequim, WA 98382-3266
Phone (360) 406-2036

Other names 2

  • Lavender Vision Doing business as
  • Lavender Vision LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260623002436 WA Part B Supplier - Clinic/Group Practice 5698248540 Receives reassigned benefits from 1 practitioner
Practice locations: Sequim, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1164365367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823266",
            "telephone_number": "360-406-2036",
            "fax_number": "360-406-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823266",
            "telephone_number": "360-406-2036",
            "fax_number": "360-406-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "KEISTER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "360-406-2036",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lavender Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lavender Vision LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.